Willow Creek Dental Pc

LBN: Willow Creek Dental Pc
Willow Creek Dental Pc is an health care organization with primary practice located at 1380 Latah Ave , Idaho Falls ID 83402. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Willow Creek Dental Pc can be contacted via phone (208) 552-0919, or through Gordon, Brandon D via phone (208) 552-0919.

Contact Information

Primary practice address
1380 Latah Ave Idaho Falls ID 83402
Phone: (208) 552-0919
Fax: (208) 552-1010
Website:
Map and Directions
Authorized official contact:
Name: Gordon, Brandon D Doctor of Dental Surgery (DDS)
Phone: (208) 552-0919

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X D-4179 Idaho

Profile Details

NPI number 1780819516
LBN Legal business name Willow Creek Dental Pc
DBA Doing business as
Authorized official Gordon, Brandon D Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 22nd, 2009
Last updated May 22nd, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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